title: An easy access to retrieve dental implants displaced into the maxillary sinus: the bony window technique.
abstract: OBJECTIVE
  To present the authors' experience concerning the removal of dental implants displaced in the maxillary sinus via an intraoral approach consisting of the creation of a bony window pedicled to the maxillary sinus membrane.
  
  
  METHODS
  Thirty-six systemically healthy patients, presenting with oral implants displaced into the maxillary sinus, but with no signs of acute or chronic sinusitis, were consecutively treated between 2002 and 2012 via an intraoral approach with the bony window technique.
  
  
  RESULTS
  Removal of oral implants from the maxillary sinus was achieved in all patients, and postoperative recovery was uneventful in all of them. Computed tomographies performed after surgery showed no signs of residual sinus infection in all patients and a complete ossification of the bony window margins. Twelve of the 36 treated patients were treated with a sinus grafting procedure 12-18 months after in the same areas previously treated with the bone lid technique. Seventeen implants were placed in the grafted areas 6-9 months later and, after a further waiting period needed for osseointegration, the treated patients were rehabilitated with implant-supported prostheses. The survival rate of implants was 100%, and no complications related to the sinuses and implants were recorded.
  
  
  CONCLUSIONS
  Results from this study seem to demonstrate that the bony window technique is a safe and easy way to remove oral implants from the maxillary sinus under local anesthesia. The surgical access is hardly visible 6-12 months after surgery, and maxillary sinuses appeared free from residual pathology in all treated patients. Finally, this procedure allows a second-stage sinus grafting procedure via a lateral approach as in a previously untreated maxillary sinus, thus allowing an implant-supported prosthetic restoration.
authors.affiliation: Unit of Maxillo-Facial Surgery, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Biglioli
authors.forename: Matteo
authors.initials: M
authors.lastname: Chiapasco
mesh_terms: D000328:Adult; D000368:Aged; D015921:Dental Implants / Q000009:adverse effects*; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010012:Osteogenesis / Q000502:physiology; D010027:Osteotomy / Q000379:methods; D059745:Piezosurgery / Q000379:methods; D011862:Radiography, Panoramic / Q000379:methods; D059546:Sinus Floor Augmentation / Q000379:methods; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D015921:Dental Implants
keywords: complication; displacement; intraoral approach; maxillary sinus; oral implant; sinusitis